1. Joint Contracting and Accreditation Process Nottingham City Council and NHS Nottingham City CCG

2. Agenda Service SpecificationsResidential and Nursing Continuing Health Care Joint Contract and MonitoringCurrent process What will change? Joint Contact Accreditation process What are the benefits? Break Accreditation ProcessWhat this will involve? What will providers need to do? Advice and support available AOBLearning Disability Respite Provision Quality Review of Care Homes Close

3. Residential Care Service Specification Rasool Gore Lead Commissioning Manager

4. Why?  Set out standard requirements for all residential care.  Service users and their carers expectations.  High profile media cases.  Legislative changes and responsibilities on Local Government.  Government expectations.

5. How?  Reviewed what the current contract arrangements are.  Consultation with operational and procurement colleagues.  Operational colleagues and procurement colleagues represented at project team meetings.  Came out and talked with some providers.  Carried out consultation events with the public.  Carried out consultation in January 2014 with providers via the web.  Information was given at a provider event on the 28 th January 2014.  The consultation and research informed the changes to the draft specification.

6. What Next? We have highlighted the key changes/additions on the revised service specification Consultation period on the web www.nottinghamcity.gov.uk/CCPnews from today until the 21 st of November www.nottinghamcity.gov.uk/CCPnews Email messages and reminders will be sent to providers. Some of these things are already part of current contracts that are being delivered 1 2 3 4

7. Conclusion  Once consultation comes to an end the Service Specification may be revised.  It will be taken to the Executive Board for approval.  The Service Specification with the contract will form the basis of the new arrangements.  There are hard copies of the Service Specification – have a browse.

8. The Current Process  Nottingham City Council: contracts with providers of Nursing and Residential care home services based on CQC registration.  NCC contract is a core contract – in place since 2011.  NHS Nottingham City CCG - NHS standard contract with the other CCGs in East Midlands – different phases commencing 2011.  Providers who wish to deliver Continuing Health Care (CHC) services need to apply through a separate process via Health.  Providers are only able to apply for CHC services at certain times determined by East Midlands CCGs with no local control.  Contracts are managed and monitored separately: - correspondence and contract actions are separate, - providers receive two separate annual quality monitoring visits.

9. What will change? Joint Contract  From 1 April 2015 current contracts for residential, nursing and CHC care will be replaced by a new joint contract with Nottingham City Council and NHS Nottingham City CCG.  The Council will be the Lead Commissioner – managing the contract on behalf of NCC and NHS.  The joint contract will be the standard NHS Contract terms and conditions.  The new contract will incorporate the new revised service specifications, quality monitoring schedule and reporting requirements.  Joint monitoring approach.  Regular data collection will be required from Providers.

10. What will change? Accreditation Process  Joint accreditation process to select providers to be contracted from 1 st April 2015  The accreditation process will be our procurement process for residential, nursing care and CHC services in Nottingham City and Nottinghamshire County  Enables us to check providers against the same set of standards prior to being awarded contracts.  This will create a list of accredited providers of residential and nursing care home services within Nottingham City and Nottinghamshire County  The list will be available to support citizens and their families/carers in the choice of care home  NCC and CCG will share responsibility for the process.

11. The Benefits!  Streamlined contracting arrangements, creating efficiencies for providers and commissioners.  Providers will only need to go through one process  All providers will have the opportunity to apply to deliver NHS Continuing Health Care – by completing the same accreditation process.  Applying to be a NHS Continuing Health Care provider will become a much less onerous process  Providers no longer need to wait until EM CCGs ‘open’ the process to apply for Continuing Health Care  The accreditation process will remain open on an ongoing basis for applications from providers not initially accredited or new providers entering the market

12. The Benefits! cont…  The new contract terms, service specification and quality schedule aim to drive greater consistency and quality in service provision.  Nottingham City Council and NHS Nottingham City CCG will have a shared understanding of issues.  A more streamlined approach will help providers - less duplication / confusion, more consistent approach.  One contract management function.  Providers will only receive one annual quality monitoring visit.  More focused approach to monitoring visits.  Where required Providers will only need to supply one action plan.  Supports Government agenda for better integration of Health and Social Care services.

13. Accreditation Process – What You need to know  Application pack emailed to all care home providers in the City and County early December 2014.  Will include: accreditation form, instructions, draft service specification, quality schedule, reporting requirements and contract terms and conditions.  Read the information carefully and complete all the questions in the accreditation form.  Applications must be from the organisation registered with CQC.  Providers with more than one home in the city and/or County will only need to complete one form and refer to all homes included in the application.

14. Accreditation Process – What You need to know cont…  Providers may apply to deliver NHS Continuing Health Care using the same application form.  Support will be available to providers throughout the process.  Providers will be able to ask questions and seek clarifications. Responses will be shared with all Providers.  Applications must be received by the closing date specified.  During the assessment Providers may be contacted for further information or to clarify responses.

15. Accreditation Process – What You need to know cont…  Contract will be effective from 1 st April 2015.  Approved providers will be issued with the contract terms and conditions with the service specification, quality schedule and reporting requirement.  A list of accredited Providers will be available to citizens and their families/carers to support them to make an informed choice.  Providers who do not complete and return an application form will not be included on the list of accredited providers.  The process will remain open on an ongoing basis for providers not initially accredited or new providers entering the market.  Only accredited providers will be awarded a contract to deliver services commissioned by Nottingham City Council and NHS Nottingham City CCG from 01 April 2015.

16. Support  Form is mainly Yes or No questions.  Continuing Health Care – need to outline how you meet the service specification (500 words).  E-mail  www.nottinghamcity.gov.uk/CCPnews www.nottinghamcity.gov.uk/CCPnews  Further support: Richard Kent richard.kent@nottinghamcity.gov.uk 0115 8764457

17. Learning Disability Respite Provision Clare Gilbert Lead Commissioning Manager

18. Five Key Areas of Activity  Market Analysis  Market Intervention  Procurement  Quality and Contract Management  Communication and Citizen Engagement Quality Review of Care Homes

19. Market Analysis  Number of beds.  Distribution of homes (by ward).  Market shares.  Financial assessment.  Quality scores.  Current and future older people population estimates.  Undertake joint accreditation process between NCC and NHS Nottingham City for residential and nursing care services.  Develop and issue joint contract for residential and nursing care services – NCC and NHS Nottingham City. Procurement

20. Market Intervention Targeted approach to commissioning of care home provision.  What is the need for Nursing Care (no. of homes/beds required)?  What are the barriers and levers to providing required levels of nursing care?  How do we stimulate provision, including new providers to the city? (new build/ conversion, staffing, payment models etc.) Improving leadership, management, staff quality and development  Identify and training and development needs from Quality monitoring.  Improve leadership capacity within Care Homes.  Care Home Managers/Leaders Network to share good practice, address issues.  Develop appropriate training programme(s) or signpost to existing training provision.

21.  Development of Quality in Care Dashboard.  Early Intervention Team for Care Homes where there are quality concerns.  Quality monitoring of residential and nursing care services using revised Quality Monitoring Framework - includes provider quality assurance processes.  Streamline monitoring between Nottingham City Council and Health to reduce overlaps and length of visits. Define a joint quarterly monitoring framework within new contracts.  Quality Monitoring workshops. Quality and Contract Management Communication and Citizen Engagement  Develop citizen engagement plan to identify their views on provision.